NEEDLE THORACOSTOMY FAILS TO DETECT A FATAL TENSION PNEUMOTHORAX

被引：28

作者：

MINES, D

ABBUHL, S

机构：

[1] Emergency Department, Department of Medicine, University of Pennsylvania, Philadelphia

来源：

ANNALS OF EMERGENCY MEDICINE | 1993年 / 22卷 / 05期

关键词：

PNEUMOTHORAX; THORACOSTOMY;

D O I：

10.1016/S0196-0644(05)80809-1

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Needle thoracostomy is an emergency procedure used to both diagnose and initially treat a tension pneumothorax. We report a case of fatal tension pneumothorax in an intubated patient with chronic obstructive pulmonary disease that was missed by this technique. A tension pneumothorax involving only the right middle and lower lobes was found at autopsy. The autopsy also suggested that needle thoracostomy was misleading because it sampled air from a noncommunicating bulla in the right upper lobe rather than from the pleural space. Tension physiology can exist with only localized collapse of a lung, and diagnostic needle thoracostomy can be falsely negative. When tension pneumothorax is strongly suspected, if empiric thoracentesis does not vent air under pressure, subsequent tube thoracostomy is indicated.

引用

页码：863 / 866

页数：4

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